Commonwealth Medical Group, LLC
Organization Active NPI Internal Medicine Physician · West Allis, WI
NPI 1477500361 · NPPES record last updated Oct 9, 2007
Key facts
- NPI
- 1477500361
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- COMMONWEALTH MEDICAL GROUP, LLC
- Practice address
- 851 S 70TH St
Suite 101
West Allis, WI 53214-3147 - Phone
- (414) 777-5100
- Fax
- (414) 777-5112
- NPI assigned
- May 27, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. John A. Mutschelknaus
- Title
- Executive Director
- Phone
- (414) 777-5100
Practitioners 91
-
Jeffrey A. Aldred, M.D.
-
Richard D. Basile, M.D.
-
Thomas F Berns, M.D.
-
Thomas R. Brand, M.D.
-
Robert E. Brueggeman, M.D.
-
Frederick K. Bulacan, M.D.
-
Richard Bush, DO
-
Kenneth Clark, M.D.
-
Mark A. Clemence, M.D.
-
Ronald I. Cohen, M.D.
-
Debra A. Corbett, P.A.
-
Stephen J. Desidero, M.D.
-
Cheryl J. Dominski, M.D.
-
Andy J. Feld, P.T.
-
Scott D. Fenske, M.D.
-
Thomas G Fenske, M.D.
-
Michelle L. Ferguson, P.T.
-
Mary J. Fischer, O.T.R.
-
Constance M. Ganapes, M.D.
-
Andrew E Gottheardt, OTR/L, CHT
National Provider Directory
Locations
7400 W Rawson Ave
Ste G40
Franklin, WI 53132
Phone (414) 282-5314
7400 W Rawson Ave
Ste 143
Franklin, WI 53132
Phone (414) 425-7380
4848 S 76th St
Ste S110
Greenfield, WI 53220
Phone (414) 817-5740
4848 S 76th St
Ste 220
Greenfield, WI 53220
Phone (414) 282-3620
5757 S 108th St
Hales Corners, WI 53130
Phone (414) 425-1303
6080 S 108th St
Hales Corners, WI 53130
Phone (414) 282-5314
2025 W Oklahoma Ave
Ste 121
Milwaukee, WI 53215
Phone (414) 671-1711
3238 S 16th St
Milwaukee, WI 53215
Phone (414) 643-4430
2500 W Layton Ave
Ste 220
Milwaukee, WI 53221
Phone (414) 281-3444
851 S 70th St
Ste 101
West Allis, WI 53214
Phone (414) 777-5100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian |
133V00000X | 1314-029 | WI | |
| Family Medicine Physician |
207Q00000X | |||
| Internal Medicine Physician |
207R00000X | Yes | ||
| Cardiovascular Disease Physician |
207RC0000X | |||
| Pulmonary Disease Physician |
207RP1001X | |||
| Nuclear Cardiology Physician |
207UN0901X | |||
| Pediatrics Physician |
208000000X | |||
| Physical Medicine & Rehabilitation Physician |
208100000X | |||
| Diagnostic Radiology Physician |
2085R0202X | |||
| Diagnostic Ultrasound Physician |
2085U0001X | |||
| Physical Therapist |
225100000X | |||
| Hand Physical Therapist |
2251H1200X | |||
| Occupational Therapist |
225X00000X | |||
| Physician Assistant |
363A00000X |
Addresses
Primary practice location
851 S 70TH St
Suite 101
West Allis, WI 53214-3147
Mailing address
851 S 70TH St
Suite 101
West Allis, WI 53214-3147
Phone (414) 777-5100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 21251000 | Medicaid | WI |
Other providers in West Allis, WI
- Brian Coleman
- Craig Coleman
- Eileen Collins
- Ligeia J'N Collins
- Shawana Collins
- Jennifer Lynn Comp
- Compassionate Home and Hospice Care, LLC
- Complete Chiropractic and Rehab Center of West Allis LLC
- Comprehensive Health Services, LLC
- Cecily Conard
All providers in West Allis, WI · Internal Medicine Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.